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The robot makes a handsome coatrack.  My local regional hospital bought one, but only has one uro doc using it.  The long and the short of it is that it does have some clinical value, but using the da Vinci takes longer and is not reimbursed more than not using it.  After the new robot smell wears off, docs are usually back to doing their previous non-robotic techniques.  Turnover is pretty high.  How many robots can you sell?  Once the hospitals have them, the disposable use goes down over time.  Neat technology, somewhat irrelevant in use.  Hospital CEOs buy them so that they can put up the billboard.